Subtalar distraction arthrodesis through a posterior approach.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery

Background:

• Subtalar arthrodesis is a common treatment for subtalar arthrosis.
• Standard lateral approaches can be challenging for correcting hindfoot deformities requiring distraction.
• Alternative medial or two-incision approaches also present difficulties in achieving distraction and angular correction.

Purpose of the Study:

• To present an alternative posterior Achilles tendon-splitting approach for subtalar fusion.
• To evaluate the efficacy of this posterior approach in achieving distraction and angular correction of hindfoot deformities.
• To assess the clinical and radiographic outcomes of subtalar fusion using the posterior approach.

Main Methods:

• Six patients with varus or valgus deformities underwent subtalar fusion via a posterior approach.
• Distraction was achieved using laminar spreaders, and fixation with two cannulated screws.
• Patients were followed until fusion, with clinical and radiographic results recorded.

Main Results:

• Radiographic fusion was achieved in all patients by 3 months postoperatively.
• No significant wound complications were reported.
• Successful correction of varus/valgus deformities to neutral or slightly valgus alignment was achieved, with significant increases in talocalcaneal height and angular measurements (p < 0.05).

Conclusions:

• The posterior approach for subtalar distraction arthrodesis is a safe and effective alternative to standard lateral techniques.
• This method provides adequate exposure for distraction and correction of varus or valgus deformities.
• It allows for successful bone grafting and achieves satisfactory radiographic and clinical results.